Closing Remarks on the Future of Dermatologic Care in NSCLC

The evolution from reactive to proactive dermatologic management represents a paradigm shift in supportive care for patients with EGFR-mutated non–small cell lung cancer. The COCOON study highlights how initial drug development focuses primarily on efficacy and acute toxicities, often overlooking long-term management strategies for chronic adverse events. This proactive approach should become standard practice for all patients receiving EGFR-targeting therapies, paralleling the established precedent of prophylactic antiemetics in chemotherapy regimens.

Future developments in dermatologic adverse event prevention include emerging topical therapies such as calcineurin inhibitors and topical BRAF inhibitors, though cost and manufacturing challenges currently limit widespread adoption. The evolution mirrors antiemetic management, which progressed from basic interventions to sophisticated multiclass prophylactic regimens over decades. Integration of dermatology specialists into oncology care teams could optimize management, similar to how palliative care, nutrition, and social work have become integral components of comprehensive cancer care.

The broader implications extend beyond dermatologic management to fundamental principles of supportive care in oncology. As targeted therapies enable longer survival with chronic treatment regimens, proactive management of predictable adverse events becomes increasingly important. Future drug development should incorporate prophylactic strategies from early-phase trials rather than addressing them post-approval. The success of the COCOON protocol establishes a framework for managing adverse events associated with other targeted therapies, emphasizing the importance of quality of life alongside efficacy in modern cancer treatment paradigms.